Subfoveal neovascular lesions in age-related macular degeneration. Guidelines for evaluation and treatment in the macular photocoagulation study. Macular Photocoagulation Study Group

The Macular Photocoagulation Study (MPS) guidelines for interpreting angiograms of eyes with subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration and for treating these lesions are described to assist ophthalmologists in applying the results of the MPS clinical trials of laser treatment. The MPS criteria for treatment of subfoveal neovascular lesions require the following conditions: (1) the presence of classic CNV, (2) well-demarcated lesion boundaries, and (3) size less than or equal to 3.5 disc areas (if no previous treatment of CNV in the macula was performed). In subfoveal recurrent CNV, size had to be such that after treatment of the recurrence, the final treatment scar (prior treatment scar and newly treated area) would be no larger than 6 disc areas and would spare some retina within 1500 microns of the center of the foveal avascular zone. Treatment of all classic and occult CNV and areas in which the boundaries of CNV may be obscured is recommended, as it treatment extending at least 100 microns beyond the peripheral boundaries of the lesion. In subfoveal recurrent CNV, treatment should also extend at least 300 microns into the previous treatment scar and cover any feeder vessels. The desired end point for the intensity of the laser burns is a uniformly white lesion.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Autologous Transplantation of RPE with Partial-Thickness Choroid after Mechanical Debridement of Bruch Membrane in the Rabbit
Hu et al.
IOVS 2008;49:3185-3192.
ABSTRACT | FULL TEXT  

Influence of Intraoperative Course on Visual Outcome after an RPE-Choroid Translocation
Maaijwee et al.
IOVS 2008;49:758-761.
ABSTRACT | FULL TEXT  

Polypoidal choroidal vasculopathy appearing as classic choroidal neovascularisation on fluorescein angiography
Tamura et al.
Br. J. Ophthalmol. 2007;91:1152-1159.
ABSTRACT | FULL TEXT  

Two-year results of surgical removal of choroidal neovascular membranes related to non-age-related macular degeneration
Essex et al.
Br. J. Ophthalmol. 2007;91:649-654.
ABSTRACT | FULL TEXT  

Fundus autofluorescence in exudative age-related macular degeneration
McBain et al.
Br. J. Ophthalmol. 2007;91:491-496.
ABSTRACT | FULL TEXT  

Quantitative Fluorescein Angiographic Analysis of Choroidal Neovascular Membranes: Validation and Correlation with Visual Function
Chakravarthy et al.
IOVS 2007;48:349-354.
ABSTRACT | FULL TEXT  

Ranibizumab versus Verteporfin for Neovascular Age-Related Macular Degeneration
Brown et al.
NEJM 2006;355:1432-1444.
ABSTRACT | FULL TEXT  

Intravitreal Bevacizumab for Choroidal Neovascularization Caused by AMD (IBeNA Study): Results of a Phase 1 Dose-Escalation Study.
Costa et al.
IOVS 2006;47:4569-4578.
ABSTRACT | FULL TEXT  

Carboxyethylpyrrole oxidative protein modifications stimulate neovascularization: Implications for age-related macular degeneration
Ebrahem et al.
Proc. Natl. Acad. Sci. USA 2006;103:13480-13484.
ABSTRACT | FULL TEXT  

Evolving European guidance on the medical management of neovascular age related macular degeneration.
Chakravarthy et al.
Br. J. Ophthalmol. 2006;90:1188-1196.
ABSTRACT | FULL TEXT  

Plasma apolipoproteins and risk for age related maculopathy
Dashti et al.
Br. J. Ophthalmol. 2006;90:1028-1033.
ABSTRACT | FULL TEXT  

Lesion morphology in age-related macular degeneration and its therapeutic significance.
Beaumont and Kang
Arch Ophthalmol 2006;124:807-812.
ABSTRACT | FULL TEXT  

Occult With No Classic Subfoveal Choroidal Neovascular Lesions in Age-Related Macular Degeneration: Clinically Relevant Natural History Information in Larger Lesions With Good Vision From the Verteporfin in Photodynamic Therapy (VIP) Trial: VIP Report No. 4.
Writing Committee for the VIP Study Group
Arch Ophthalmol 2006;124:660-664.
ABSTRACT | FULL TEXT  

Combined photodynamic therapy and intravitreal triamcinolone injection for the treatment of subfoveal choroidal neovascularisation in age related macular degeneration: a comparative study.
Chan et al.
Br. J. Ophthalmol. 2006;90:337-341.
ABSTRACT | FULL TEXT  

Retinal Anastomosis to Choroidal Neovascularization: A Bum Rap for a Difficult Disease
Bressler
Arch Ophthalmol 2005;123:1741-1743.
FULL TEXT  

Autofluorescence Imaging of Choroidal Neovascularization Due to Age-Related Macular Degeneration
Dandekar et al.
Arch Ophthalmol 2005;123:1507-1513.
ABSTRACT | FULL TEXT  

Optical coherence tomography guided retreatment of photodynamic therapy
Krebs et al.
Br. J. Ophthalmol. 2005;89:1184-1187.
ABSTRACT | FULL TEXT  

Correlation of optical coherence tomography, with or without additional colour fundus photography, with stereo fundus fluorescein angiography in diagnosing choroidal neovascular membranes
Sandhu and Talks
Br. J. Ophthalmol. 2005;89:967-970.
ABSTRACT | FULL TEXT  

Laser Induces Apoptosis and Ceramide Production in Human Retinal Pigment Epithelial Cells
Barak et al.
IOVS 2005;46:2587-2591.
ABSTRACT | FULL TEXT  

Histopathologic and Ultrastructural Features of Surgically Excised Subfoveal Choroidal Neovascular Lesions: Submacular Surgery Trials Report No. 7
Submacular Surgery Trials Research Group
Arch Ophthalmol 2005;123:914-921.
ABSTRACT | FULL TEXT  

Verteporfin Therapy of Subfoveal Minimally Classic Choroidal Neovascularization in Age-Related Macular Degeneration: 2-Year Results of a Randomized Clinical Trial
Visudyne in Minimally Classic Choroidal Neovascula
Arch Ophthalmol 2005;123:448-457.
ABSTRACT | FULL TEXT  

Photodynamic Therapy With Verteporfin: Observations on the Introduction of a New Treatment Into Clinical Practice
Schein et al.
Arch Ophthalmol 2005;123:58-63.
ABSTRACT | FULL TEXT  

Surgical Removal vs Observation for Subfoveal Choroidal Neovascularization, Either Associated With the Ocular Histoplasmosis Syndrome or Idiopathic: I. Ophthalmic Findings From a Randomized Clinical Trial: Submacular Surgery Trials (SST) Group H Trial: SST Report No. 9
Submacular Surgery Trials Research Group
Arch Ophthalmol 2004;122:1597-1611.
ABSTRACT | FULL TEXT  

CAI Is a Potent Inhibitor of Neovascularization and Imparts Neuroprotection in a Mouse Model of Ischemic Retinopathy
Franklin et al.
IOVS 2004;45:3756-3766.
ABSTRACT | FULL TEXT  

Morphometric Analysis of Angiograms of Exudative Lesions in Age-Related Macular Degeneration
Ali et al.
Arch Ophthalmol 2004;122:710-715.
ABSTRACT | FULL TEXT  

Relative Contributions of Reduced Vision and General Health to NEI-VFQ Scores in Patients With Neovascular Age-Related Macular Degeneration
Miskala et al.
Arch Ophthalmol 2004;122:758-766.
ABSTRACT | FULL TEXT  

Photodynamic Therapy for Occult Choroidal Neovascularization With Pigment Epithelium Detachment in Age-Related Macular Degeneration
Axer-Siegel et al.
Arch Ophthalmol 2004;122:453-459.
ABSTRACT | FULL TEXT  

Natural History of Minimally Classic Subfoveal Choroidal Neovascular Lesions in the Treatment of Age-Related Macular Degeneration With Photodynamic Therapy (TAP) Investigation: Outcomes Potentially Relevant to Management--TAP Report No. 6
Bressler et al.
Arch Ophthalmol 2004;122:325-329.
ABSTRACT | FULL TEXT  

Predilection of the Macular Region to High Incidence of Choroidal Neovascularization After Intense Laser Photocoagulation in the Monkey
Shen et al.
Arch Ophthalmol 2004;122:353-360.
ABSTRACT | FULL TEXT  

The Complications of Age-Related Macular Degeneration Prevention Trial (CAPT): rationale, design and methodology
The Complications of Age-Related Macular Degenerat
Clin Trials 2004;1:91-107.
ABSTRACT  

Palladium-103 plaque radiation therapy for macular degeneration: results of a 7 year study
Finger et al.
Br. J. Ophthalmol. 2003;87:1497-1503.
ABSTRACT | FULL TEXT  

Photodynamic Therapy of Subfoveal Choroidal Neovascularization With Verteporfin: Fluorescein Angiographic Guidelines for Evaluation and Treatment--TAP and VIP Report No. 2
Treatment of Age-Related Macular Degeneration With
Arch Ophthalmol 2003;121:1253-1268.
ABSTRACT | FULL TEXT  

Digital analysis of choroidal neovascularisation in consecutive fluorescein angiograms for use in longitudinal clinical trials
Bellmann et al.
Br. J. Ophthalmol. 2003;87:890-892.
ABSTRACT | FULL TEXT  

Sequence of Early Vascular Events after Photodynamic Therapy
Michels and Schmidt-Erfurth
IOVS 2003;44:2147-2154.
ABSTRACT | FULL TEXT  

Retinal Pigment Epithelium Wound Healing in Human Bruch's Membrane Explants
Wang et al.
IOVS 2003;44:2199-2210.
ABSTRACT | FULL TEXT  

A Randomized Clinical Trial of a Single Dose of Intravitreal Triamcinolone Acetonide for Neovascular Age-Related Macular Degeneration: One-Year Results
Gillies et al.
Arch Ophthalmol 2003;121:667-673.
ABSTRACT | FULL TEXT  

Identification of lesion components that influence visual function in age related macular degeneration
Hogg et al.
Br. J. Ophthalmol. 2003;87:609-614.
ABSTRACT | FULL TEXT  

One year follow up of macular translocation with 360 degree retinotomy in patients with age related macular degeneration
Abdel-Meguid et al.
Br. J. Ophthalmol. 2003;87:615-621.
ABSTRACT | FULL TEXT  

CNV subtype in first eyes predicts severity of ARM in fellow eyes
Abugreen et al.
Br. J. Ophthalmol. 2003;87:307-311.
ABSTRACT | FULL TEXT  

Subconjunctival Doxifluridine Administration Suppresses Rat Choroidal Neovascularization through Activated Thymidine Phosphorylase
Yanagi et al.
IOVS 2003;44:751-754.
ABSTRACT | FULL TEXT  

Verteporfin Therapy of Subfoveal Choroidal Neovascularization in Patients With Age-Related Macular Degeneration: Additional Information Regarding Baseline Lesion Composition's Impact on Vision Outcomes--TAP Report No. 3
Treatment of Age-Related Macular Degeneration With
Arch Ophthalmol 2002;120:1443-1454.
ABSTRACT | FULL TEXT  

Visual Outcomes in the Subfoveal Radiotherapy Study: A Randomized Controlled Trial of Teletherapy for Age-Related Macular Degeneration
Hart et al.
Arch Ophthalmol 2002;120:1029-1038.
ABSTRACT | FULL TEXT  

Decreased Visual Acuity Associated With Cystoid Macular Edema in Neovascular Age-related Macular Degeneration
Ting et al.
Arch Ophthalmol 2002;120:731-737.
ABSTRACT | FULL TEXT  

Eligibility for treatment and angiographic features at the early stage of exudative age related macular degeneration
Haddad et al.
Br. J. Ophthalmol. 2002;86:663-669.
ABSTRACT | FULL TEXT  

Transpupillary Thermotherapy for Subfoveal Occult Choroidal Neovascularization: Effect on Ocular Perfusion
Ciulla et al.
IOVS 2001;42:3337-3340.
ABSTRACT | FULL TEXT  

Can {blacktriangledown}verteporfin help in macular degeneration?
DTB 2001;39:30-32.
ABSTRACT | FULL TEXT  

Photodynamic Therapy of Subfoveal Choroidal Neovascularization in Age-Related Macular Degeneration With Verteporfin: Two-Year Results of 2 Randomized Clinical Trials--TAP Report 2
Treatment of Age-Related Macular Degeneration With
Arch Ophthalmol 2001;119:198-207.
ABSTRACT | FULL TEXT  

Extracts from "Clinical Evidence": Age related macular degeneration
Arnold and Sarks
BMJ 2000;321:741-744.
FULL TEXT  

Correlation of Histologic 2-Dimensional Reconstruction and Confocal Scanning Laser Microscopic Imaging of Choroidal Neovascularization in Eyes With Age-Related Maculopathy
Grossniklaus et al.
Arch Ophthalmol 2000;118:625-629.
ABSTRACT | FULL TEXT  

Histological examination of the pigment epithelium-Bruch membrane-choriocapillaris complex after macular translocation
BERECZKI et al.
Br. J. Ophthalmol. 2000;84:546f-546.
FULL TEXT  

Clinicopathological correlation in exudative age related macular degeneration: histological differentiation between classic and occult choroidal neovascularisation
Lafaut et al.
Br. J. Ophthalmol. 2000;84:239-243.
ABSTRACT | FULL TEXT  

Photodynamic Therapy of Subfoveal Choroidal Neovascularization in Age-related Macular Degeneration With Verteporfin: One-Year Results of 2 Randomized Clinical Trials--TAP Report 1
Treatment of Age-related Macular Degeneration With
Arch Ophthalmol 1999;117:1329-1345.
ABSTRACT | FULL TEXT  

Photocoagulation of subfoveal choroidal neovascular membranes in age related macular degeneration: the impact of the macular photocoagulation study in the United Kingdom and Republic of Ireland
BEATTY et al.
Br. J. Ophthalmol. 1999;83:1103-1104.
FULL TEXT  

Photodynamic Therapy With Verteporfin for Choroidal Neovascularization Caused by Age-related Macular Degeneration: Results of a Single Treatment in a Phase 1 and 2 Study
Miller et al.
Arch Ophthalmol 1999;117:1161-1173.
ABSTRACT | FULL TEXT  

Photodynamic Therapy With Verteporfin for Choroidal Neovascularization Caused by Age-related Macular Degeneration: Results of Retreatments in a Phase 1 and 2 Study
Schmidt-Erfurth et al.
Arch Ophthalmol 1999;117:1177-1187.
ABSTRACT | FULL TEXT  

Long term results of radiotherapy for subfoveal choroidal neovascularisation in age related macular degeneration
Chiquet et al.
Br. J. Ophthalmol. 1999;83:923-928.
ABSTRACT | FULL TEXT  

Dynamics of phosphorothioate oligonucleotides in normal and laser photocoagulated retina
Shen et al.
Br. J. Ophthalmol. 1999;83:852-861.
ABSTRACT | FULL TEXT  

Radiotherapy for isolated occult subfoveal neovascularisation in age related macular degeneration: a pilot study
Donati et al.
Br. J. Ophthalmol. 1999;83:646-651.
ABSTRACT | FULL TEXT  

Indocyanine green angiographic features prognostic of visual outcome in the natural course of patients with age related macular degeneration
Obana et al.
Br. J. Ophthalmol. 1999;83:429-437.
ABSTRACT | FULL TEXT  

Alternative therapies in exudative age related macular degeneration
CHONG and BIRD
Br. J. Ophthalmol. 1998;82:1441-1443.
FULL TEXT  

Case-control study of the risk factors for age related macular degeneration
Chaine et al.
Br. J. Ophthalmol. 1998;82:996-1002.
ABSTRACT | FULL TEXT  

Evaluating New Retinal Imaging Techniques
Bressler
Arch Ophthalmol 1998;116:521-522.
FULL TEXT  

Apoptosis in Surgically Excised Choroidal Neovascular Membranes in Age-Related Macular Degeneration
Hinton et al.
Arch Ophthalmol 1998;116:203-209.
ABSTRACT | FULL TEXT